title: The Impella device for acute mechanical circulatory support in patients in cardiogenic shock.
abstract: BACKGROUND
  Acute cardiogenic shock is associated with high mortality rates. Mechanical circulatory devices have been increasingly used in this setting for hemodynamic support. The Impella device (Abiomed Inc, Danvers, MA) is a microaxial left ventricular assist device that can be inserted using a less invasive technique. This study was conducted to determine the outcome of patients who have undergone placement of the Impella device for acute cardiogenic shock in our institution.
  
  
  METHODS
  A retrospective record review of 47 patients who underwent placement of the Impella device was performed from January 1, 2006, to December 31, 2011. Records were evaluated for demographics, operative details, and postoperative outcomes. Operative mortality was defined as death within 30 days of the operation.
  
  
  RESULTS
  The patients (33 male) were an average age of 60.23 ± 13 years. The indication for placement of the Impella device included cardiogenic shock in 15 patients (32%) and postcardiotomy cardiogenic shock in 32 (68%). Of the 47 patients, 38 (80%) received the Impella 5.0 and the rest the 2.5 device. Ventricular function recovered in 34 of 47 patients (72%), and the device was removed, with 4 patients (8%) transitioned to long-term ventricular assist devices. The 30-day mortality was 25% (12 of 47 patients). Complications occurred in 14 patients (30%), consisting of device malfunction, high purge pressures, tube fracture, and groin hematoma.
  
  
  CONCLUSIONS
  This is one of the largest series of patients undergoing placement of the Impella device for acute cardiogenic shock. Our outcomes showed improved results compared with historical data. Myocardial recovery was accomplished in most patients. Finally, the 30-day mortality and complication rate was acceptable in these critical patients. These benefits were all achieved with the Impella device in a less invasive method.
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts. Electronic address: lemairan@umdnj.edu.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lemaire
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts.
authors.forename: Mark B
authors.initials: MB
authors.lastname: Anderson
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts.
authors.forename: Leonard Y
authors.initials: LY
authors.lastname: Lee
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts.
authors.forename: Peter
authors.initials: P
authors.lastname: Scholz
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts.
authors.forename: Thomas
authors.initials: T
authors.lastname: Prendergast
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts.
authors.forename: Andrew
authors.initials: A
authors.lastname: Goodman
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Lozano
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts.
authors.forename: Alan
authors.initials: A
authors.lastname: Spotnitz
authors.affiliation: Department of Cardiothoracic Surgery, Robert Wood Johnson University Hospital, The University of Medicine and Dentistry of New Jersey, New Brunswick, New Jersey; and Abiomed, Inc, Danvers, Massachusetts.
authors.forename: George
authors.initials: G
authors.lastname: Batsides
mesh_terms: D000208:Acute Disease; D000368:Aged; D015331:Cohort Studies; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005500:Follow-Up Studies; D006353:Heart-Assist Devices; D006439:Hemodynamics / Q000502:physiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality* / Q000503:physiopathology; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: 27